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NPI Code Detail

MEDICARE: HEAVENLY ANGELS HOME CARE SERVICES

MEDICARE: HEAVENLY ANGELS HOME CARE SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency
2253Z00000XIn Home Supportive Care Agency
3372600000XAdult Companion
4376J00000XHomemaker

General Provider Information

NPI Number : 1275035826
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEAVENLY ANGELS HOME CARE SERVICES
Provider Business Mailing Address
First Line : 517 COUNT AVE
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-8630
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 517 COUNT AVE
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-8630
Country : US
Telephone Number : 702-778-7440
Fax Number :
Authorized Official
Title or Position : OWNER
Name : LUCY FAJARDO
Credential :
Telephone Number : 702-778-7440
Provider Enumeration Date : 02/28/2018
Last Update Date : 04/18/2022

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Directions to “HEAVENLY ANGELS HOME CARE SERVICES ” Practice Location

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